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沙库巴曲缬沙坦与他汀类药物联合治疗中肌肉系统不良反应信号的检测

Detection of muscular system adverse reaction signals in sacubitril/valsartan treatment combined with statins.

作者信息

Zhao Fukun, Luo Min, Wang Yuanmin, Su Mu, Tang Fei

机构信息

Department of Clinical Pharmacy, Third Affiliated Hospital of Zunyi Medical University (The First People's Hospital of Zunyi), Zunyi, Guizhou, China.

Department of Pain Medicine, Suiyang County Hospital of Traditional Chinese Medicine, Zunyi, Guizhou, China.

出版信息

Front Pharmacol. 2024 Jul 15;15:1393616. doi: 10.3389/fphar.2024.1393616. eCollection 2024.

Abstract

OBJECTIVE

To detect muscular system adverse reaction signals of sacubitril/valsartan treatment combined with statins (atorvastatin, rosuvastatin, simvastatin) to provide a reference for clinical administration.

METHODS

Multiplicative and additive models were used to mine the FDA's spontaneous reports database to detect signals of drug-drug interactions between sacubitril/valsartan and statins. SAS 9.4 software was used to conduct statistical tests for suspicious signals to determine whether the signals were statistically significant.

RESULTS

A total of 8,883,870 adverse reaction reports were analyzed. The combinations "sacubitril/valsartan - simvastatin - musculoskeletal muscle pain" had statistically significant correlation signals in both models ( < 0.05). The combination "sacubitril/valsartan - atorvastatin - myopathy" and "sacubitril/valsartan-simvastatin - myopathy" had statistically significant correlation signal in the multiplicative model ( < 0.05).

CONCLUSION

Compared with a single drug, coadministration of sacubitril/valsartan with atorvastatin may increase safety risks to myopathy, with simvastatin may increase safety risks to the musculoskeletal pain and myopathy, which should be closely monitored in clinical practice.

摘要

目的

检测沙库巴曲缬沙坦与他汀类药物(阿托伐他汀、瑞舒伐他汀、辛伐他汀)联合治疗时的肌肉系统不良反应信号,为临床用药提供参考。

方法

采用相乘模型和相加模型挖掘美国食品药品监督管理局(FDA)自发报告数据库,以检测沙库巴曲缬沙坦与他汀类药物之间的药物相互作用信号。使用SAS 9.4软件对可疑信号进行统计检验,以确定这些信号是否具有统计学意义。

结果

共分析了8,883,870份不良反应报告。“沙库巴曲缬沙坦-辛伐他汀-肌肉骨骼肌肉疼痛”组合在两个模型中均具有统计学意义的相关信号(<0.05)。“沙库巴曲缬沙坦-阿托伐他汀-肌病”和“沙库巴曲缬沙坦-辛伐他汀-肌病”组合在相乘模型中具有统计学意义的相关信号(<0.05)。

结论

与单一药物相比,沙库巴曲缬沙坦与阿托伐他汀联合使用可能增加肌病的安全风险,与辛伐他汀联合使用可能增加肌肉骨骼疼痛和肌病的安全风险,临床实践中应密切监测。

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